Abstract [en]

Background: In 2012 Sweden created its first natinal program and knowledge base for palliative care. Palliative care is described by the Swedish National Board through four bases, symptom relifes, multi-professional cooperation, support to relatives, and communication and relationship. It is usually the nurse that identifies the need for palliation, but the doctor is the one that makes the decision to begin palliative care. This can be a long process and cause the child unnecessary suffering. Aim: To describe the intensive care nurses experiences in ending life support and the transition to palliative care of children intensive care. Method: The study was conducted as a qualitative interview study. Six individual semi-structured interviews with intensive care nurses at a childrens intensive care unit in Sweden was carried out . These interviews were analyzed on the basis of Elo and Kygnäs method of qualitative content analysis and resulted in three main categories. Result: The nurses' experiences of withdrawing lifesustaining treatment and the transition to palliative care was presented in the result within three main categories, ”The irrevocable life”, ”The end of life” and ”What can the nurse do for the family?”. Conclusion: To discontinue life-sustaining care and transition to palliative care is a complex and difficult ethical decision.